Intracranial metastases in small cell carcinoma of the lung: correlation of clinical and autopsy findings
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Intracranial metastases in small cell carcinoma of the lung : correlation of clinical and autopsy findings. / Hirsch, F R; Paulson, O B; Hansen, H H; Vraa-Jensen, J.
In: Cancer, Vol. 50, No. 11, 01.12.1982, p. 2433-7.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Intracranial metastases in small cell carcinoma of the lung
T2 - correlation of clinical and autopsy findings
AU - Hirsch, F R
AU - Paulson, O B
AU - Hansen, H H
AU - Vraa-Jensen, J
PY - 1982/12/1
Y1 - 1982/12/1
N2 - Two hundred-twelve consecutive patients with small cell carcinoma of the lung were included in an evaluation of clinical and diagnostic neurologic findings of intracranial metastases. A correlation of premortem findings to postmortem examination of the brain was obtained in 87 of the patients. Clinical intracranial metastases were diagnosed in 21.2% on the basis of symptoms and signs. At autopsy 44 of the 87 patients (50%) had metastases. Lesions located to the posterior cranial fossa were demonstrated in 53% of the positive autopsies. A correlation of 96% existed between significant premortem clinical findings and positive autopsy, while 33% had clinically "silent" metastases at autopsy. A neuro-oncologic examination was performed in 49 patients at the time of presentation of neurologic symptoms. Twenty-eight patients were considered to have intracranial metastases. Gait disturbances were the presenting signs in more than 50% of the patients. Brain metastases were demonstrated at autopsy in 14 of 15 patients considered to have intracranial metastases by the neuro-oncologist, and clinically "silent" metastases were observed in one out of 10 patients. Radionuclide brain scan was negative in seven of 13 patients in spite of "positive" neuro-oncological examination had a subsequent positive autopsy. Cerebrospinal fluid examination was of no value in the diagnosis of brain metastases. It is concluded that a careful clinical examination by a neuro-oncologist is of great value in early detection of brain metastases, especially in diagnosing metastases to the posterior cranial fossa.
AB - Two hundred-twelve consecutive patients with small cell carcinoma of the lung were included in an evaluation of clinical and diagnostic neurologic findings of intracranial metastases. A correlation of premortem findings to postmortem examination of the brain was obtained in 87 of the patients. Clinical intracranial metastases were diagnosed in 21.2% on the basis of symptoms and signs. At autopsy 44 of the 87 patients (50%) had metastases. Lesions located to the posterior cranial fossa were demonstrated in 53% of the positive autopsies. A correlation of 96% existed between significant premortem clinical findings and positive autopsy, while 33% had clinically "silent" metastases at autopsy. A neuro-oncologic examination was performed in 49 patients at the time of presentation of neurologic symptoms. Twenty-eight patients were considered to have intracranial metastases. Gait disturbances were the presenting signs in more than 50% of the patients. Brain metastases were demonstrated at autopsy in 14 of 15 patients considered to have intracranial metastases by the neuro-oncologist, and clinically "silent" metastases were observed in one out of 10 patients. Radionuclide brain scan was negative in seven of 13 patients in spite of "positive" neuro-oncological examination had a subsequent positive autopsy. Cerebrospinal fluid examination was of no value in the diagnosis of brain metastases. It is concluded that a careful clinical examination by a neuro-oncologist is of great value in early detection of brain metastases, especially in diagnosing metastases to the posterior cranial fossa.
KW - Autopsy
KW - Brain Neoplasms/diagnosis
KW - Carcinoma, Small Cell/pathology
KW - Humans
KW - Lung Neoplasms/pathology
KW - Palliative Care
KW - Prednisone/therapeutic use
U2 - 10.1002/1097-0142(19821201)50:11<2433::aid-cncr2820501131>3.0.co;2-e
DO - 10.1002/1097-0142(19821201)50:11<2433::aid-cncr2820501131>3.0.co;2-e
M3 - Journal article
C2 - 6182974
VL - 50
SP - 2433
EP - 2437
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 11
ER -
ID: 276072756